Article type
Abstract
Introduction
Guidelines that are based on the best available evidence are key to strengthening health systems and enhancing equitable health access. However, a guideline development process can be complex and resource intensive. The Global Evidence, Local Adaptation (GELA) project supports researchers’ and decision-makers’ capacity to use global evidence to develop locally relevant child and newborn health guidelines in Malawi, Nigeria, and South Africa.
Aim
To describe our experience with developing guidelines and share lessons learned in Malawi.
Methods
A team was established to develop recommendations on the timing of initiating enteral feeding for critically ill children in inpatient settings. A process of identifying priority topics for Malawi was supported by a Steering Group and a Guideline Development Group (GDG), both selected in partnership with and with guidance from the Ministry of Health. The capacity of GDG members around guideline development methods was assessed. A standard protocol collectively developed by collaborating partners was used.
Results
An initial project introduction, close collaboration with the Ministry of Health (MoH), and a stakeholder analysis helped ensure a mutual understanding of the project’s objectives and facilitated several aspects of the guideline development process. Targeted initiatives were implemented to build capacity for GDG members and GELA staff, including introduction to systematic reviews, guideline development methods, and evidence-to-decision framework-based guideline development simulation. These were complemented by virtual "learning by doing" sessions for GELA staff. Most importantly, regular meetings across the GELA project and collaborative working on the required tasks facilitated learning. Additionally, a community of practice was initiated to create space and opportunities for sharing of experiences and expertise on guideline development components.
Conclusion
GELA demonstrated how to use experiential learning to contextualize processes and create a model for evidence-based guideline development. The process was iterative, and several decisions built on the experience gained from implementing the project. Lessons learned from this process will provide a basis for further developing a contextualized process of guideline development in similar settings to improve the health of the population.
Consumer Relevance
Consumer representatives were involved in topic prioritization. Evidence-informed guidelines impact practice and policies affecting outcomes in all groups.
Guidelines that are based on the best available evidence are key to strengthening health systems and enhancing equitable health access. However, a guideline development process can be complex and resource intensive. The Global Evidence, Local Adaptation (GELA) project supports researchers’ and decision-makers’ capacity to use global evidence to develop locally relevant child and newborn health guidelines in Malawi, Nigeria, and South Africa.
Aim
To describe our experience with developing guidelines and share lessons learned in Malawi.
Methods
A team was established to develop recommendations on the timing of initiating enteral feeding for critically ill children in inpatient settings. A process of identifying priority topics for Malawi was supported by a Steering Group and a Guideline Development Group (GDG), both selected in partnership with and with guidance from the Ministry of Health. The capacity of GDG members around guideline development methods was assessed. A standard protocol collectively developed by collaborating partners was used.
Results
An initial project introduction, close collaboration with the Ministry of Health (MoH), and a stakeholder analysis helped ensure a mutual understanding of the project’s objectives and facilitated several aspects of the guideline development process. Targeted initiatives were implemented to build capacity for GDG members and GELA staff, including introduction to systematic reviews, guideline development methods, and evidence-to-decision framework-based guideline development simulation. These were complemented by virtual "learning by doing" sessions for GELA staff. Most importantly, regular meetings across the GELA project and collaborative working on the required tasks facilitated learning. Additionally, a community of practice was initiated to create space and opportunities for sharing of experiences and expertise on guideline development components.
Conclusion
GELA demonstrated how to use experiential learning to contextualize processes and create a model for evidence-based guideline development. The process was iterative, and several decisions built on the experience gained from implementing the project. Lessons learned from this process will provide a basis for further developing a contextualized process of guideline development in similar settings to improve the health of the population.
Consumer Relevance
Consumer representatives were involved in topic prioritization. Evidence-informed guidelines impact practice and policies affecting outcomes in all groups.